Background: Pancreatic ductal adenocarcinoma (PDAC) is one of the most difficult cancers to treat, with a dismal 5-year survival rate of only 8–10%. This challenging prognosis highlights the urgent need for innovative therapeutic approaches to improve outcomes for patients with PDAC. Electrochemotherapy (ECT), which enhances intracellular chemotherapeutic uptake via electric pulses, has been explored for resectable, borderline resectable (BR), locally advanced (LA), recurrent, and metastatic PDAC, either as a complement to conventional treatments or as an alternative when these are not feasible or effective, offering possible benefits in symptomatic palliation and local tumor control. Methods: A systematic review was performed in accordance with PRISMA guidelines for studies assessing the efficacy of ECT in PDAC. After searching Embase, PubMed/MEDLINE, Scopus, and Web of Science, five studies with a combined total of 43 patients in various disease stages were identified. Results: ECT showed promise in improving tumor control, alleviating cancer-related pain, and improving quality of life. One study noted a trend towards tumor size reduction of 8.3% at one-month and 16.1% at six-months follow-up (p= 0.211 andp= 0.315), although these findings were derived from studies conducted without specific comparative control groups. Severity of complication was mainly mild (Clavien–Dindo I-II), while severe complications occurred in only 2.3% of patients. Median overall survival was reported in two studies as 8 months (range 2–19) and 11.5 months (range 1–74). ECT showed efficacy for symptom management, with 60% of patients reporting reduced pain/discomfort and 40% showing enhanced quality of life in one study, while another reported pain scores as decreasing from 6 to 3 at one month and to 2 at six months. Conclusions: ECT appears to be a new promising and safe adjunct treatment modality in PDAC management across different disease stages, with potential benefits in tumor control, cancer-related pain reduction, and quality of life. Further studies are warranted to validate these findings and identify patients who could benefit most.
背景：胰腺导管腺癌（PDAC）是最难治疗的癌症之一，其五年生存率仅为8-10%，预后极差。这一严峻现状凸显了开发创新疗法以改善PDAC患者预后的迫切需求。电化学疗法（ECT）通过电脉冲增强化疗药物的细胞内摄取，已被探索用于可切除、临界可切除（BR）、局部进展期（LA）、复发及转移性PDAC的治疗。该疗法可作为常规治疗的补充，或在常规治疗不可行或无效时作为替代方案，在缓解症状和局部肿瘤控制方面可能带来获益。 方法：本研究遵循PRISMA指南，对评估ECT在PDAC中疗效的研究进行了系统性综述。通过检索Embase、PubMed/MEDLINE、Scopus和Web of Science数据库，共纳入5项研究，涵盖不同疾病阶段的43例患者。 结果：ECT在改善肿瘤控制、缓解癌性疼痛及提高生活质量方面显示出潜力。一项研究指出，随访1个月和6个月时肿瘤体积呈现缩小趋势（分别缩小8.3%和16.1%，p=0.211和p=0.315），但这些结果来自未设置特定对照组的非对照研究。并发症严重程度主要为轻度（Clavien–Dindo I-II级），严重并发症发生率仅为2.3%。两项研究报告的中位总生存期分别为8个月（范围2-19个月）和11.5个月（范围1-74个月）。在症状管理方面，一项研究显示60%患者疼痛/不适减轻，40%患者生活质量改善；另一项研究报道疼痛评分在1个月时从6分降至3分，6个月时降至2分。 结论：ECT似乎是一种新型且有前景的安全辅助治疗方式，适用于不同阶段的PDAC管理，在肿瘤控制、减轻癌性疼痛和提高生活质量方面具有潜在获益。仍需进一步研究验证这些发现，并明确最能从中获益的患者群体。
肿瘤(癌症)患者之家